Healing Patients with a Healthy Landscape

Ronnie Ayers of Piedmont Landscaping & Maintenance at the courtyard between two office buildings at the Greenville Hospital System’s Patewood campus.

Patients on the upper floors of Patewood Memorial Hospital must wonder if they’re seeing things when they see grass growing on the roof below them.

Nearly an acre of fescue is growing right on top of the operating room; not only does the turf give patients a more pleasant view, it also provides insulation and reduces rainwater runoff.

This is just one of the ways the Greenville Hospital System (GHS) in Greenville, S.C., is using landscaping to enhance the quality of the patient experience.

All this is being done at a time of tight budgets—emphasizing conservation of resources while keeping up with the demands of a rapidly growing, six-campus system encompassing some 500 acres in three counties.

Making sure the grounds are well-maintained is one of the responsibilities of Perry McFall, director of community facilities engineering for GHS. He works closely with Ronnie Ayers and his company, Piedmont Landscaping & Maintenance, Inc., which has been doing the job for some 20 years.

Photo Courtesy of Piedmont Landscaping & Maintenance, Inc.

Sod is installed on the roof of Patewood Memorial Hospital.

The grounds are designed to make a stay at the hospital as pleasant as possible, with entrances setting the tone. “I think the main thing we want to do is just provide a pleasant experience,” McFall said. “We take a lot of pride in our entrances. That’s a place that his crew focuses a tremendous amount on, making them look pretty with seasonal plantings, and making sure we have something nice there year-round.”

Ayers relies on zero-turn riding mowers by Exmark and Toro, and push mowers by Scag and Snapper. The trimmers he uses are made by Husqvarna.

Cutting back

A big challenge recently has been dealing with the financial constraints of a down economy.

McFall said, “GHS, system-wide, has tightened the belt to try to cut our expenses and maintain things in the manner we’re normally used to seeing, but we are trimming back across the board.”

Turning back the faucet was part of that effort, driven by the continuing drought in the region. Water use was cut by 40 percent during the 2008 growing season.

Photo Courtesy of Piedmont Landscaping & Maintenance, Inc.

A load of sod is hoisted to the roof of PatewoodMemorial Hospital for installation.

An employee of Piedmont Landscaping &Maintenance, Inc. prepares to vacuumleaves from the parking lot of PatewoodMemorial Hospital.

“Fescue is tough,” Ayers said. “We had to trade some aesthetics for conservation during this past year. We had to shut some water down and just let the fescue brown out, and we learned some lessons from it. It’ll turn brown and it’ll look ugly, but when it rains, it’ll come back. It recovers.”

The hospital system voluntarily reduced its water usage before the drought became severe. “We anticipated problems,” McFall said.

All of the campuses use Rain Bird irrigation, with the newest sites controlled by a Tucor two-wire system.

“I can control Patewood, the research building at Greenville Memorial and Greer [Medical Campus] from a Web-based unit,” Ayers said. “It tells me how much water is used; I can change the timed zones on it.”

He uses drip irrigation as much as possible on shrubs, but even so, he’s being conservative.

“Once those shrubs get established you can pretty much cut the drip off. That’s another way we’re trying to save on water,” Ayers said.

Rooftop turf

Although only seen by patients and employees on the upper floors of the Patewood hospital, the turf-covered rooftop is one of the more unusual features of the GHS grounds.

The 33,000-square-foot rooftop was covered with a 12-inch layer of Stalite, an expanded slate product. The lightweight material had to be used on the roof for structural reasons. “Weight is a serious factor,” Ayers said.

Ayers was surprised at how quickly the Rebel II fescue/bluegrass mix from Turf Mountain Sod in Hendersonville, N.C., took off. “Believe it or not, we laid that fescue sod on it and we watered it, and about two weeks later those roots had just taken off through that stuff,” Ayers said.

The benefits of the turf roof are many, beyond the aesthetic value for patients.

“Not only does it help with stormwater runoff, because you get so much retention in the grass area when it rains, but it’s an insulator, too, in the winter and in the summer,” Ayers said.

The sod yields an R-100 insulation value—more than three times the value on a typical house with about R-30 efficiency, McFall said.

Regular nitrogen-based fertilizers can’t be used on the roof because they’re caustic and could damage utility infrastructure in the roof, so Ayers uses Milorganite organic fertilizer and adds iron to achieve a dark green color without heavy nitrogen applications. He cautions that iron can stain if not applied carefully.

Electric mowers are used to cut the grass for minimal disruption to patients. The roof is irrigated with a four-station Rain Bird system, and drains into the gutters like a normal roof, although the amount of runoff is reduced, Ayers said.

Parking deck turf

Another rooftop in disguise is the courtyard between two doctors’ office buildings on top of a two-level parking garage.

The garden was built in a 3.5-foot-deep planter filled with a mixture of peat, perlite and bark chips. “It was a challenge because we couldn’t take any big machinery out there to fill those ‘swimming pools,’ as I call them,” Ayers said. “It took a while to get that done.”

Photo Courtesy of Piedmont Landscaping & Maintenance, Inc.

Azaleas add springtime color to the Patewood hospital campus.

The courtyard was planted with Asiatic jasmine, black-eyed Susans, crepe myrtles and other perennials. “This is our showplace in the summertime, when all the perennials are flowering and the crepe myrtles are blooming,” Ayers said.

The courtyard, like most of the Patewood campus, was sodded with Rebel II fescue. A nearby field used by patients of a sports injury facility is sodded with 419 bermudagrass. Ayers uses some Panama bermuda seed in other areas. Most of the older parts of the hospital system’s other campuses have bermudagrass.

A planter of annuals gives winter coloroutside the hospital.

Healing gardens

Healing gardens are featured on the grounds at Greenville Memorial, the flagship campus, and North Greenville, a long-term, acute-care facility.

“You try to use some seasonal color so things are happening year-round, but mostly try to have it looking as good in February as it’s looking in April,” Ayers said.

As in all areas near the hospitals, special care is used in applying chemicals. “We try not to use liquid chemicals very much because of drip and movement,” Ayers explained. He uses granular herbicides and does most spraying on the weekends, when fewer people are around. Most of the fertilizers and chemicals are purchased from Lesco.

Ayers has a four-man crew assigned full-time to the Patewood campus, and another four-man crew dedicated to Greer Medical Campus, plus six men at Greenville Memorial. At the other campuses, he sends crews in once or twice a week as needed.

In the wintertime, the crews are busy mulching—alternating double-ground hardwood mulch with pine straw—pruning and applying preemergent herbicides.

“We try to be proactive for spring,” he explained. “Anything we can do to make spring easier, that’s what we do in the wintertime.”

Ron Barnett is a freelance writer and has been a frequent contributor to Turf over the years. He resides in Easley, S.C., and is always on the lookout for new and interesting stories in the Carolinas, Georgia and east Tennessee.